1. Field of the Invention
This invention is in the field of equipment used for intravascular medical procedures, specifically flexible elongated members such as guidewires and catheters that are introduced into a patient's blood vessel.
2. Background Art
Invasive vascular procedures like balloon angioplasty and stent implantation require insertion of a guide catheter into the vasculature, usually in the femoral (leg) artery and directing the catheter to the vasculature in need of treatment, such as the heart. Through this catheter, a thin (for example 0.014 inch) wire called a guidewire, is introduced and threaded down the artery to be treated. An additional catheter or other flexible elongated member can be introduced over, or alongside, the guidewire.
The catheter prior art is replete is variations. For example, rapid exchange catheters are also used, where a guidewire enters a lumen in the distal tip of the catheter and then exits anywhere from about 1 cm to 40 cm from the distal tip, running alongside the catheter but outside of the same. In “over-the-wire” catheters, the guidewire runs inside the catheter throughout its length.
At times, the operator must treat or protect more than one vessel using the same guide catheter. In this circumstance, the operator passes two or more pairs of flexible elongated members through the same Y adaptor. The multiple flexible elongated members travel down the same guide catheter and then enter the vessel requiring treatment, with each guidewire and its associated catheter usually entering a different vessel or branch vessel in need of treatment.
The multiple guidewires and their respective catheters enter the guide catheter through the sealable entry site of the Y adaptor. Since the guidewire/catheter pairs have the same point of entry at the Y adaptor, the operator must take steps to keep the wire/catheter pairs separate from each other, and to keep each guidewire identified with the correct catheter. It is important to keep the wire/catheter pairs separate for several reasons. If the wire/catheter pairs become twisted, they will interact with one another; for instance, when the operator moves one wire or catheter, another wire or catheter may also move. Further, different devices, such as stents, are typically passed over the guidewires on the catheters; therefore, if the wire/catheter pairs become twisted with each other, accurate advancement of the associated devices is hindered. Also, since different devices are passed over the different wires on the catheters, the operator must take steps to identify each wire so as not to confuse which wire is going down which vessel or branch vessel.
Currently, the prevalent method of separating wire/catheter pairs is to use layers of sterile towels. However, towels are bulky and difficult to control. Towels securing guidewires also lie on the operative field and if the Y adaptor is moved, the towels tend to stay in place, so that the guidewires may be inadvertently pulled out of the vessel.
A procedure can often involve the use of two wire/catheter pairs, or sometimes even three or four. Typically, the physician takes up a guidewire and its associated catheter and works with them, then puts them down and takes up a different wire/catheter pair and works with it. In the process, the free ends of the wire/catheter pairs outside the Y adaptor can become wrapped around each other. During a complicated procedure, the free ends of the wire/catheter pairs can become greatly interwoven. The cause of this problem is that the various wire/catheter pairs exit through the same port in the Y adaptor, and that their free ends are more or less free to lie along somewhat parallel paths on the surgical field, hindering adequate identification, control, or organization.
It is an object of the present invention to provide an apparatus which will allow the operator to efficiently identify, organize, and manage two or more pairs of guidewires and their associated catheters. It is also an object of the present invention to provide a device for catheter and guidewire management that can be conveniently secured in place to an operating field.